What we did

Researchers at the NIHR Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC) have created the Safe Medication Dashboard (SMASH), which is a pharmacist-led digital intervention that improves patient safety when prescribing medication in general practice.

 

SMASH was trialled in Salford with impressive results; in addition to substantially reducing the numbers of at-risk patients, the reduction was sustained after 12 months. This success led to the decision to roll out SMASH across all 10 localities in Greater Manchester.

This roll out is being led by Health Innovation Manchester, in partnership with the NIHR GM PSTRC.
 
 

Why was it important?

Medication errors leading to adverse drug events are a major healthcare problem, and one that has been acknowledged recently by the third WHO Global Patient Safety Challenge. A study of English general practices identified errors in 5% of medicine prescriptions. In most cases the consequences of such errors will be negligible because the medications that are prescribed carry very low risk, but the sheer volume of prescribing (over one billion prescription items supplied in the community in England each year) means that avoidable deaths in primary care due to medication errors are seven times more likely than in hospitals. Improving the safety of drug prescribing in primary care has therefore been recognised a priority by the NHS.

 
How we did it

We focused on identifying and solving implementation barriers within different localities and capturing the effects on serious harm outcomes. Specifically, we will answer the following research questions:

 

• How was SMASH scaled-up and spread across Greater Manchester?
• What organisation infrastructure and support was needed to implement and sustain the SMASH across different localities?
• What were the factors which, in the opinion of local stakeholders, contributed to or detracted from the spread and scale-up of SMASH?
• What were the effects of the GM-wide roll-out of SMASH on the safety of drug prescribing in primary care? What were the effects on associated adverse events such as kidney failure, life-threatening bleeds, and asthma exacerbations?

 

This involved a mixed methods approach:

 

• Qualitatively - we undertook non-participant observations, interviews and focus groups with staff responsible for the delivery and implementation of SMASH, along with a document analysis. 
• Quantitatively - we looked at electronic health records from general practices and hospitals to assess whether the introduction of SMASH has led to a reduction of potentially hazardous medication prescriptions and associated adverse events.

 

Who we worked with?

• Health Innovation Manchester
• NIHR Greater Manchester Patient Safety Translational Research Centre
• Greater Manchester Health and Social Care Partnership
• Graphnet Health

 

 

More Information

 

 

 

Head of ARC-GM

 

Sue Wood